In the limited attention the international media has paid to Liberian, Sierra Leonean and Guinean people’s experiences and thoughts on Ebola an interesting metaphor has frequently come up – that of comparing Ebola to war.
“The Ebola outbreak has been like someone firing live bullets” – Emmett P Chea, Liberia (http://www.bbc.com/news/29331061). “Just imagine living somewhere where you are being invisibly terrorized” – Lucy Sherman, Liberian in the US (http://www.abcactionnews.com/news/hillsborough-regional-news/ebola-worries-from-home-follow-ut-student)
This has been in the context of either comparing the virus to war generally, as above, or comparing it specifically to the civil wars that Liberians and Sierra Leoneans have endured.
“Then, we could see our enemy, but now the enemy is unknown and could be a loved one or close associate” – Simitie Lavaly, Sierra Leone (http://www.theguardian.com/global-development/2014/oct/15/ebola-sierra-leone-pariah-nation).
It is not only the inhabitants themselves that are using this sort of language but seemingly journalists and aid workers familiar with war settings also find this comparison useful in attempts to describe the situation:
“…the country is fighting a “biological war” from an unseen enemy without foot soldiers” – Sarah Crowe, UNICEF Liberia (http://www.bbc.com/news/world-africa-29147797).
“… I really feel that it is like wartime, in terms of fear and no one knowing what is going on.” – Dr. Joanne Liu, MSF President (http://news.sky.com/story/1319044/ebola-epidemic-is-like-war-time-says-msf).
It is perhaps not particularly remarkable that people choose this metaphor for what most certainly is a silent killer, apparently striking without notice and prejudice. Metaphors of war are also far from being only confined to post-conflict societies and are also quite common in Western societies. In this light it makes sense that many people in the midst of the crisis see the similarities to war and use that frame of language to explain their fears and despair. In addition, this might also be a way to try to explain to a highly militarized world the gravity of the situation. I do however want to point out the obvious here, Ebola isn’t the same as war (and I am not suggesting that any of the people quoted above actually believe this to be the case). Therefore although it might be a useful metaphor, going to the extent of responding to it as if it equals war is problematic, for the lack of a stronger word.
The securitized and militarized responses we are witnessing in regards to Ebola at the moment are of course not coming out of nowhere but form part of a trend that has been evolving for some time. The securitization of health has globally been on the increase for the last decades, with outbreaks of bird flu, SARS and swine flu resulting in various degrees of concern and alarm, often causing irrational fear and paranoia. To some extent the securitization of particular health issues have probably been a calculated move done in order to attract both more attention and much needed resources. In a world that spends over 1.7 trillion USD on military alone (not taking into account funding spent on other security measures) it is difficult to criticize those that simply seek resources where they are to be found. This trend however might lead the international community towards some questionable responses, not in line with the nature of the problems faced.
One of the many problems in relation to securitizing health issues, be it Ebola or something else, is that it allows for the response to be more robust and intruding into people’s daily lives. This can be taken to the extent of potentially ignoring people’s human rights. This has already been made evident in the use of the curfew currently in place in Monrovia, which seems to have a vague purpose in regards to bringing the spread of Ebola to a halt and rather function as a form of population control. The curfew has also seemingly lead to an increase in night time crime such as armed robbery and rape, bringing a whole new security dimension to the issue.
A more concrete example would be the 10 day quarantine imposed on the neighbourhood of West Point in Monrovia in August. This was recommended by military officials but advised against by health officials. As predicted by those opposed to the idea the quarantine only lead to social chaos, further anger and distrust against the government, and degradation of already dire living conditions with the rise in prices of basic necessities. This medieval type of response was not even successful in its objective of stopping traffic of people in and out of the area. Many of the inhabitants found ways to continue getting in and out, mainly through bribery to police and military officers.
A related problem in regards to securitized responses is that they might lead to poorly thought out political measures, aimed at calming a panicked population (voters) rather than getting at and resolving the root cause of the medical issue. An evaluation conducted on the efficiency of border control response in regards to SARS in Canada 2003 (St John et al, 2005) concurs that these kind of responses are ineffective in the least and possibly harmful at worst. These types of responses take precious resources (and a substantial amount of resources) away from more effective ways of handling the outbreaks (such as strengthening health care).
Another securitized response based more on panic than strategic Ebola prevention is the use of quarantine and isolation measures. This includes the quarantining of airplanes where a suspected Ebola patient is on board and isolation of various individuals that do not need to be isolated based on scientific knowledge of Ebola. These isolations and quarantines are probably party done due to precaution and partly to calm the public. This is a delicate matter though and there is some evidence in support to the theory that in fact the overuse of quarantines and isolations rather induces fear within the general population. On top of that it is in danger of imposing stigma upon those in quarantine, in addition to the economic and psychological difficulties faced by such measures.
Securitized measures are also in danger of taking on racist characteristics, closing borders and engraining fear against certain “types” of people, as was evident in racist notions against people from East-Asia following the SARS epidemic. This can be seen now towards inhabitants of Liberia, Sierra Leone and Guinea in public discourse. This is also felt to an increasing degree by West-Africans residing outside their countries with a growing number of anecdotal evidence in regards to people being stigmatized due to their origins. The discrimination has to some degree extended to all West-Africans, and even all Africans. There are concrete examples such as the cancelling of flights by Korea Air to Nairobi, Kenya, and the voluntary temporary absence from school by two Rwandan children in New Jersey, USA. In addition the anecdotal evidence of people being forbidden entry from public places, asked not to attend conferences they had already been invited to, and being shunned or mocked for coming from African countries continues accumulating.
In regards to the current response to Ebola, the international community has possibly taken one step further towards the overall securitization of health. On the 18th of September the United Nations Security Council made history by holding the first ever emergency meeting on a health issue. At this meeting resolution 2177 was also adopted concerning the Ebola response. Prior to this only two other SC resolutions had addressed a health issue (1308 and 1983) both of which were on HIV/AIDS. One of the arguments for the securitization of HIV/AIDS has been that armed forces are in particular susceptible to the virus, hence suggesting that the virus can directly lead to less efficacy of these institutions. The former resolutions are very much based on this kind of thinking and focus on peace-keepers and their vulnerability to HIV/AIDS (1308) as well as arguing that the virus is a problem in post-conflict communities and needs to be taken into account in peacebuilding operations (1983). Resolution 2177 is thus the first health related SC resolution purely focusing on a health emergency without referring to peace-keepers or peacebuilding measures. Whether this is the beginning of a new trend remains to be seen. The adoption of the resolution did of course not occur in a vacuum though but at the same time as President Obama announced that the US would be contributing to the Ebola response by sending 3000 troops to Liberia (SC resolution 2177 was sponsored by the US, although with 130 co-sponsors).
These members of the US military are to set up 17 health shelters with 100 beds each. This is much needed and these shelters will presumably fill up fast, by patients that is, since the US military is not planning on providing the staff needed for these shelter. Obama has been very clear in his response to national criticism on sending US citizens into an Ebola zone that none of these people will come anywhere near an Ebola patient. Instead the intention is to train 500 Liberian health workers for a week, every week, for an unknown period of time. This is incredibly ambitious given, for example, the complex protocol for using and removing the protective suit, and as recent examples from Spain and the US depict how this can easily be breached with serious consequences. It therefore seems that this response is only providing half the tools needed and is leaving the desperately needed medical staff out of the equation. This has sadly been characteristic for the current international response.
As mentioned above, the securitization of health issues is probably often lead by activists hoping for a quicker and better funded response, which is all well and good. What makes this approach problematic is if that means that the response and resources spent are not in line with the needs on the ground. Even more problematic is when these responses make matters worse by ignoring the human rights of populations and encourage measures based on racist notions of “contaminated” people. The “war” on Ebola will have to be fought by doctors, nurses, medical support staff, ambulance drivers, and burial teams. In addition it will have to be fought by the ordinary men and women of Liberia, Sierra Leone and Guinea who now quickly need to learn the tricks of dealing with a new threat among them using the resilience and coping mechanisms they already possess. Military might in all its glory will not be able to conquer this enemy.
Gudrun Sif Fridriksdottir is a PhD Candidate in Social Anthropology at the University of Iceland and a Guest Researcher at the Nordic Africa Institute. She has previously worked on gender and peacebuilding issues with UN Women, including in Liberia 2007-2009
St John, R. K., King, A., De Jong, D., Bodie-Collins, M., Squires, S. G., & Tam, T. W. (2005). “Border screening for SARS”. Emerging infectious diseases, 11(1), 6.